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Handwashing

February 2019. We have all learned time and time again about the importance of handwashing, and how it can reduce the risk for harmful infections and, ultimately, save lives. Then, along comes Pete Hegseth, co-host of Fox & Friends, with the statement that he has not washed his hands in 10 years. He stated the reason for this as being “germs are not a real thing – I can’t see them, therefore they’re not real.” Whether he was joking or not is still under debate, but one thing is for sure, his statement is far from being correct.

Hegseth’s statement no doubt created a lot of publicity, but many are now concerned that people will be influenced by him in not washing their hands. And they have every right to be.

The Guardian (2019) quotes Professor Val Curtis, from the London School of Hygiene and Tropical Medicine, where she states that:

“Hands are the most important vector of infectious diseases.”

Val Curtis, 2019. Retrieved from the Guardian

She adds to this that not washing your hands or improper handwashing puts everyone at risk, and that it is a moral issue above all. If, for example, you go to the washroom and don’t wash your hands, everything you touch afterwards will be contaminated. Everyone who touches the same surfaces that you did will be touching the bacteria that you have spread, putting them at high risk for infection.

Even though the risks are significant from improper handwashing, many people rarely put in the extra little effort needed in order to reduce these risks. According to Sandoz (2019), 1 in 20 people fail to wash their hands properly after using the washroom. Also, the average time that people take to wash their hands is 7 seconds, which is far below the recommended 20 seconds (Sandoz, 2019).

How to properly wash your hands

So what is considered proper handwashing and how can we achieve it in order to prevent infection? The Centre for Disease Control and Prevention (CDC) provides us with detailed steps in order to maintain ultimate hand hygiene. The steps are as follows:

Wet your hands with clean, running water (warm or cold), turn off the tap and apply soap.

Lather your hands by rubbing them together with soap. Be sure to lather the backs of your hands, between your fingers and under your nails.

Scrub your hands for at least 20 seconds.

Rinse your hands well, under clean, running water.

Dry your hands using a clean towel or air dry them

Proper handwashing is necessary to prevent the spread of infection and to ultimately save lives. It doesn’t take a lot of time or effort to do, and it can make all the difference. So do your part for yourself and society; wash your hands 🙂

Hospital-acquired infections are a serious threat in healthcare facilities today and researchers keep finding new sources of these infections. We know that sources of HAIs include surfaces, high-touch objects, hands and medical devices, but did you know that these infections can also occur due to the water and plumbing systems in healthcare facilities?

Source: Public Domain Pictures

According to Infection Control Today (2018), “Potable and utility water systems in healthcare settings are reservoirs and vectors of Hospital-acquired infections, resulting in pneumonias, bacteremias, skin infections, surgical site infections, eye infections and others.”

Hospitals are major users of potable water, whether it be for drinking, bathing, hand-washing or rinsing medical devices. It is therefore important that healthcare facilities realize that the water entering their facilities is not considered sterile.

Why is the water in plumbing systems infected? The design of and water use patterns in premise plumbing creates biofilms, which provide shelter and food for harmful bacterias. According to Infection Control Today (2018), “Biofilms in premise plumbing systems are complex ecosystems, and it is within these biofilms that bacteria, fungi and amoeba find the food, water and shelter they need.” Many bacteria develop in the biofilms, such as Legionella, Ancinetobacter aumanniii, Aspergillus flavus, etc.

Legionella – what is it and how does it affect patients in a healthcare setting?

Legionella colonies

Source: Wikimedia Commons

Legionella is one example of a bacteria that is found naturally in water. This bacteria is known for causing Legionnaires’ disease: a severe form of pneumonia. This disease is one of the most significant waterborne infections. Legionnaires normally has a mortality rate of only 10%, however, if acquired in a hospital, this rate goes up to anywhere between 25-50% (Infection Control Today, 2018)! Hospitals experience the highest number of outbreaks of Legionnaires disease (compared to other types of buildings) due to having a large number of patients with weakened immune systems or that have chronic diseases. It is important to note that the majority of Legionnaires cases in hospitals are due to the drinking water system.

How to reduce the risk of wHAIs: education and water management programs

So now that we are aware of waterborne hospital acquired infections (wHAIs), is there a way to reduce the risk that potable water poses to healthcare facilities? Infection Control Today (2018) suggests both education and water management programs as possible solutions to reducing the wHAI risk. Firstly, through education, it is important that healthcare workers know that potable water does carry bacteria and does cause an increase in HAIs. Second, once this idea of water carrying bacteria is understood, it will be important to implement water management programs. There can be no standardized water management programs, as all facilities differ in factors such as age of establishment and system, overall design of plumbing system, populations served, etc. Some hospitals have already tried different methods of water disinfection. Examples of these methods used to reduce risk include the use of sterile water in high-risk patient areas, engineering controls and point-of-use water filters.

To summarize, healthcare facilities must realize the risk that water and plumbing systems pose to their patients and employees. Hospital-acquired infections are one of the leading causes of death in North America and it is therefore crucial that hospitals take action against any source that could spread these infections. Education and water management programs are the best ways to help reduce the risk of wHAIs, according to Infection Control Today (2018).

Hygiene and cleanliness are already monitored closely in hospitals and healthcare facilities. Hand sanitation is a crucial hygiene practice for both medical professionals’ well-being, as well as their patients. However, according to TrendHunter (2014), hand hygiene compliance in US hospitals is only achieved 50% of the time. And this is only an example of hand hygiene in the US. Studies would probably show similar, if not worse, percentages in countries across the globe. That is why Biovigil invented a medical hygiene monitoring badge.

Source: Pixabay

The Biovigil monitoring badge is specifically made for hand sanitation. The badge can be clipped on to a scrub or lab coat. It reminds healthcare workers to clean their hands when they leave or enter a patient’s room. It also works by telling either healthcare professionals or patients if their hands have been properly sanitized by turning green when the worker places their hand over the monitor. The badge also collects data on hand sanitation and sends it to be analyzed. While these badges are not heavily used yet, they could prove to be very efficient in eliminating the spread of hospital-aqcuired infections.

It is not, then, unreasonable to ask what other sort of technology could be developed in order to better monitor hygiene and sanitation in healthcare facilities. With the technological resources we have today, it is highly possible to create new products such as this. For now, most hygiene monitoring technologies revolve around hand sanitation. But as we’ve seen in other posts, there are way more sources of contamination and spread of bacteria than just hands; hospital bed mattresses, marked medical instruments, surface damages on medical equipment, etc. Why not create a technology that monitors the hygiene of these things as well? Similarly to the hand sanitation monitor, there could be monitors for other medical equipments that alert healthcare cleaners to check if they are clean and safe to use.

Every parent knows it: when kids are in school, they are way more likely to get sick than when they are not. From sharing toys, chairs, desks, computer keyboards, water fountains and door handles, kids are the most prone to getting sick. Elementary and preschool students are the most prone to getting sick at school, mostly because their immune system is not fully developed yet. On average, elementary students will have 12 colds per year (yikes!). And let’s not forget that many school staff also end up getting sick from their students. So what can be done to help stop the spread of infection among students and staff?

Source: Pixabay

Sure, you can remind kids to wash their hands, cover their mouths when they cough, etc, but how effective will it really be? Schools must play a very important role in the cleaning and disinfection within their buildings in order to protect both employees and students. The primary person responsible for the upkeep of the school building is the custodian, and, as such, he should be trained in infection control methods.

The Centers for Disease Control and Prevention (CDC) makes the following recommendations on how to properly clean and disinfect schools and what procedures to follow:

Knowing the difference between cleaning, disinfecting and sanitizingThe CDC stresses the difference between the three methods of “cleaning”. While cleaning involves the removal of dirt and germs, it does not necessarily kill the bacteria. Disinfection, on the other hand, uses chemicals to kill bacterias, and does not focus on a clean surface, but rather a bacteria-free one. Finally, sanitization is the process of lowering the number of bacteria to a safe level.

Clean and disinfect surfaces that are touched oftenThis point speaks for itself; many schools already have a specific procedure regarding what should be cleaned more often, such as desks, compared to something that does not have to be cleaned often.

Do routine cleaning and disinfecting.

Clean and disinfect correctly.It’s simple to say, however, many people and institutions are not trained to know exactly what “correctly” means. It is important to pay close attention to the detailed instructions provided on the label of product.

Use products safely. Pay attention to warnings and hazards on the label of product. Make sure that proper equipment (gloves, masks, etc.) are used when necessary.

Influenza is a stubborn virus. Moreover, every year, the virus is changing and it’s another race against time to produce a new vaccine, often composed of several strains, which will be able to protect the most vulnerable population such as young children, the elderly and sick people.

AN ENCOURAGING RESEARCH on INFLUENZA

According to the article by Radio-Canada:

At Laval University, Gary Kobinger’s team is testing a new influenza vaccine, which could provide better protection and long-term immunization. The formula incorporates much of the circulating influenza strains over the last 20 years.

A first clinical trial to test the safety of the vaccine ended a few months ago. According to the researchers, it shows that the product does not cause significant side effects.

The effectiveness of vaccines against influenza (the flu) is also limited especially when we guess wrong the strain that will be the most virulent that year!

THE IMPORTANCE OF HAND WASH

We are all at one point exposed to the flu virus. A good way of individual prevention is to put on your hat on and tie your coat. I am joking. On the other hand, regular hand washing before meals, after the toilet and even just when arriving at work or at home is really an effective way against the spread of the virus.

Regular hand soaps like Utopia or antibacterial soap like Utopia AB do the trick.

Did you know that our soaps do not contain any: methyisothiazolinone?

THE IMPORTANCE OF SURFACE DISINFECTION

Cleaning worker also plays a very important role in the winter period when it comes to disinfecting surfaces. Specialty products such as the Ali-Flex line of product offers many benefits:

Handwashing is the single most important action to break down the transmission of infection. Anyone working in the food industry, in a lab or in healthcare environment will tell you how often they have to wash their hands. So many products are available, however, it is clear that not all product were created equal. Multiple claims are often written on the bottle confusing users and buyers. A lack of regulation is seen. However, recently the American FDA (Food and Drug Administration) and Health Canada seems to be going toward new regulation in order to increase the safety of hand soaps.

FDA bans Triclosan

The American FDA (Food and Drug Administration) banned the use of Triclosan and 18 other chemicals in consumer hand soap. The decision was based on the lack of information regarding the effectiveness of this product compare to regular handwashing. Also, serious doubt concerning the safety of this product was crucial in the decision process. The debate has been going on for a while before the decision was made.

Health Canada identified risk regarding Methylisothiazolinone

According to Health Canada, the repeated exposure to this substance and its derivatives can generate multiple symptoms including:

a red rash or bumps;

itching;

swelling, burning, or tenderness of the skin;

dry, cracked or scaly skin;

blisters.

These symptoms may occur each time someone uses a product containing Methylisothiazolinone and its derivatives and may become more severe with repeated use.

Multiple solutions exist

Hopefully, many suppliers offer products without triclosan, paraben, methylisothiazolinone, benzalkonium chloride, polyacrylamide, dioxane, nonylphenol ethoxylated alcohol or any chemicals of concern. Ask you supplier what are the options regarding safe hand soap, it might save you a lot of trouble.

October 15th is a day dedicated to increasing awareness and understanding about the importance of handwashing.

Handwashing is easy

Only a small amount of water and soap are necessary to accomplish a small action that provides great benefits. It takes 30 seconds and a bit of hand rubbing.

Handwashing works

Washing hands after using the toilet and before handling food can dramatically reduce the risk of infections such as foodborne infection. This year, handwashing was critical in the prevention of the Ebola virus in West Africa.

Handwashing is for everyone

We always ask children to wash their hands before eating, when they are back from school or after playing in the yard. From toddlers to elderly, handwashing never loses its importance. Infections can be transmitted by anyone to everyone. In order to protect children or elderly, everyone should wash their hands. After all, it is the most cost-effective public health intervention.